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At a glance: Blepharitis

  • Symptoms:

    Red, itchy, burning eyes or eyelids, crusty eyelids or eyelashes

  • Diagnosis:

    Eye exam

  • Treatment:

    Keeping eyelids clean and free of crusts, warm compresses, antibiotics, or steroid eye drops (in certain cases)

What is blepharitis?

Blepharitis is a common eye condition that makes your eyelids red, swollen, irritated, and itchy. It can cause crusty dandruff-like flakes on your eyelashes.  

Blepharitis can be uncomfortable. But it isn’t contagious, and it usually doesn’t cause any lasting damage to your eyes.

The main treatment for blepharitis is regularly cleaning your eyelids and keeping them free of crusts. Blepharitis usually doesn’t go away completely, but you can take steps to manage your symptoms. Talk to your eye doctor about what’s causing your blepharitis and the best ways to manage it.

What are the symptoms of blepharitis?

Common symptoms of blepharitis are:

  • Feeling like there’s something in your eye
  • Burning or stinging eyes
  • Watery eyes
  • Itchy eyes
  • Sensitivity to light
  • Red and swollen eyes or eyelids
  • Tears that are foamy or have small bubbles in them
  • Dry eyes
  • Crusty eyelids or eyelashes when you wake up

Blepharitis can also cause more serious problems like:

  • Blurry vision
  • Eyelashes that fall out
  • Eyelashes that grow in the wrong direction
  • Swelling of other parts of the eye, like the cornea

Am I at risk for blepharitis?

You’re at higher risk for blepharitis if you have:

  • Dandruff — flaky patches of skin on your scalp or face
  • Rosacea — a skin condition that causes redness and bumps, usually on your face
  • Oily skin
  • Allergies that affect your eyelashes

What causes blepharitis?

Most of the time, blepharitis happens because you have too much bacteria on your eyelids at the base of your eyelashes. Having bacteria on your skin is normal, but too much bacteria can cause problems. You can also get blepharitis if the oil glands in your eyelids get clogged or irritated.

What are the types of blepharitis?

There are 2 types of blepharitis. You may have 1 type of blepharitis, or you may have both types at the same time.

Anterior blepharitis. Anterior blepharitis affects the outside of your eye, where your eyelashes attach to your eyelid. It usually happens because of bacteria on your skin or dandruff from your scalp or eyebrows. Allergies or mites (tiny parasites) may also cause anterior blepharitis, but this is rare.

Posterior blepharitis. Posterior blepharitis affects the outside of the inner edge of the eyelid — the part that touches your eye. This type of blepharitis happens when the oil glands in your eyelids get clogged. Common skin conditions like rosacea and scalp dandruff can cause posterior blepharitis.

How will my eye doctor check for blepharitis?

Your eye doctor can check for blepharitis by doing a physical eye exam. During the exam, your doctor will take a close look at your eyes, eyelids, and eyelashes. They may use a bright light or a special magnifying tool. 

What other health problems can blepharitis cause?

Blepharitis can lead to other eye problems, including:

  • Stye. A stye is a red, painful bump on the eyelid caused by a blocked oil gland.
  • Chalazion. A chalazion is a hard, painless lump on the eyelid caused by a blocked oil gland. Often, this happens when you have a stye that doesn’t go away. It can make your eyelid swell and turn red. A chalazion will often go away on its own.
  • Dry eye. Oil and flakes can build up in your tear film (a thin layer of tears across the surface of your eye). This can make your eyes feel dry. Or your eyes may feel watery or teary because your tears aren’t working correctly. Learn more about dry eye.
  • Damage to the cornea. In severe cases, blepharitis can hurt your cornea (the clear outer layer at the front of your eye). This can happen because of swelling or irritation in your eyelids or eye lashes that grow in the wrong direction.
  • Chronic (long-term) red eye. Blepharitis can make the white part of your eye look red all the time.

What's the treatment for blepharitis?

The best way to treat blepharitis is to keep your eyelids clean and free of crusts. Use water and a gentle cleanser (like baby shampoo) to clean your eyelids and remove crusts every day.

Steps for cleaning your eyelids when you have blepharitis:

  1. Wash your hands with soap and water.
  2. Mix warm water with a gentle cleanser, like baby shampoo.
  3. Dip a clean, soft cloth or cotton swab in the warm cleanser and water mixture.
  4. Press the cloth against your closed eye for a few minutes to loosen crusts. This can also help keep your oil glands from clogging.
  5. Gently rub the cloth or cotton swab back and forth, focusing on the area where your eyelashes meet your eyelids.
  6. Rinse your eye with clean water.
  7. Repeat these steps on your other eye using a new cloth or cotton swab.

There are other treatment options that may help you manage blepharitis. Ask your eye doctor if any of these options are right for you:

  • Eye drops. Your doctor may prescribe steroid eye drops to control redness, swelling, and irritation. Your doctor may also recommend a type of eye drops called artificial tears. You can get these eye drops without a prescription.
  • Medicines that fight infection. If your blepharitis is caused by bacteria, your doctor may prescribe antibiotic eye drops, ointments, or pills.
  • Treating other health problems. If another health problem like rosacea or dandruff is causing your blepharitis, treating that condition will help.

Blepharitis usually doesn’t go away completely. You’ll need to follow a routine for cleaning your eyelids for the rest of your life to keep it under control.

Last updated: November 15, 2023